ABSTRACT
Gastrointestinal Dysfunction and Autism .................................................285 References .............................................................................................................. 291
Autism spectrum disorders (ASD) are complex debilitating neurodevelopmental disorders. Despite diagnostic advances and a broader awareness, its causes and underlying pathology remain largely a mystery. Studies have suggested both genetic and environmental components in its etiology, and much attention has been drawn toward a possible role for immune dysfunction. Indications of an increased incidence of chronic gastrointestinal (GI) disturbance in some children with ASD have also generated interest in GI dysfunction as a contributing factor to certain aspects or symptoms and even behavioral characteristics in ASD. Endoscopic, histologic, and
immunohistochemical analyses of the GI tract in children with ASD who present with GI symptoms have revealed chronic in ammatory changes throughout the gut, including extensive immune cell in ltration of the gut wall and increased pro-in ammatory responses in mucosal T-lymphocyte cells. In addition, some of the changes observed suggest the potential involvement of an autoimmune response that is directed toward the epithelial barrier surrounding the gut lumen. Here, we review evidence supporting a potential role of GI dysfunction in some cases of ASD, the potential link between immune dysfunction and gut in ammation, and the hypotheses regarding the relationship between autistic behaviors and GI-related immune dysfunction.
